J2791
HCPCS Procedure Code
HCPCS code J2791 is the #4,792 most-billed Medicaid procedure code, with $397K in payments across 7K claims from 2018–2024. The national median cost per claim is $51.62. Costs vary widely — the 90th percentile is $118.08 per claim, 2.3× the median.
Total Paid
$397K
0.00% of all spending
Total Claims
7K
Providers
56
Avg Cost/Claim
$59
National Cost Distribution
How much do providers bill per claim for J2791? Based on 44 providers billing this code nationally.
Median
$51.62
Average
$56.78
Std Dev
$48.27
Max
$222.16
Percentile Distribution (Cost per Claim)
50% of providers bill between $19.48 and $69.17 per claim for this code.
90% bill between $6.35 and $118.08.
Top 1% bill above $205.75.
About This Procedure
HCPCS code J2791 was billed by 56 providers across 7K claims, totaling $397K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.
Fraud Risk Context
Injectable drug codes carry high per-claim costs and have been involved in drug diversion and upcoding schemes.
Source: HHS OIG Reports
Risk Assessment
Billing Statistics
Median Cost/Claim
$51.62
Providers Billing
44
National Spending
$397K
Avg/Median Ratio
1.10×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2791
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1225133473 | $153K |
| 2 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $44K |
| 3 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $31K |
| 4 | Summa Health System Akron, OH · General Acute Care Hospital | $30K |
| 5 | 1467546135 | $22K |
| 6 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $19K |
| 7 | Geisinger Clinic Danville, PA · Surgery | $10K |
| 8 | Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital | $7K |
| 9 | The Good Samaritan Hospital Of Cincinnati, Ohio Cincinnati, OH · General Acute Care Hospital | $6K |
| 10 | 1104870187 | $6K |
| 11 | Aultman Hospital Canton, OH · General Acute Care Hospital | $5K |
| 12 | 1003281452 | $5K |
| 13 | 1689282147 | $5K |
| 14 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $5K |
| 15 | 1609983790 | $5K |
| 16 | 1801897038 | $5K |
| 17 | Spartanburg Medical Center Spartanburg, SC · Ambulance | $4K |
| 18 | Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory | $4K |
| 19 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $3K |
| 20 | 1790868982 | $3K |
Showing top 20 of 56 providers billing this code